Improving health while saving money? Yes, it can be done.

June 21, 2017

Photo by Gale Zucker

It turns out there’s a way to both save money and improve outcomes for high-need patients with asthma, diabetes, and other chronic conditions.

No, it’s not a new high-tech device or miracle pill. It’s something more old-fashioned: Public health workers who can build trusting relationships that bridge the gaps between the clinical care system and all the other factors in people’s lives that can influence their health. They’re known as community health workers, although they’re also sometimes referred to by titles such as health coaches, patient navigators, or peer educators.

Whatever they’re called, community health workers all serve a similar purpose: creating connections between vulnerable populations and complex health care systems. They can help patients learn to manage their chronic conditions, identify and address barriers that keep patients from taking care of their health, and help connect people to other needed services.

The foundation recently released a report outlining four programs that could be implemented in Connecticut using community health workers to target high-need patients. The programs are based on successful interventions that operate in other states. The research was done by a team from the University of Massachusetts Medical School’s Center for Health Law and Economics.

In addition to focusing on improving health outcomes, each of the programs is designed to produce a positive return on investment through reductions in direct medical costs. In other words, if implemented correctly, these programs would actually save money.

For an overview of the report and its findings, read a copy of this policy brief. If you are interested in the research behind the brief and the steps to take to implement one of these programs, the full report is available here.

And if you want to learn more about the thinking behind this project, keep reading…

What problem are we trying to address?

Community health workers offer lots of potential to the health care system: Their services have been shown to improve patient outcomes, and they can save money when working with high-need patients.

But to date, most community health worker programs have been funded by grants and other temporary sources of money, and when those run out, the community health worker services tend to disappear. The foundation is looking for ways to ensure that community health worker services can be provided in a sustainable way.

Why did we commission this report?

Although there’s a lot of research that demonstrates the value of community health worker services, it can be difficult for health care organizations to translate all the research into practice. We thought having researchers from UMass do some of the heavy lifting – examining the literature and designing programs for actual implementation – could encourage health care organizations in Connecticut to try them.

What’s in the report?

The report provides blueprints for four interventions using community health workers that could both improve health outcomes and produce a positive return on investment – that is, save more money in direct medical costs than it costs to operate the program.

Each program is targeted to a specific population of patients: Latinos with diabetes in Hartford, children with uncontrolled asthma in Greater New Haven, frequent emergency department users with behavioral health needs in New London County, and adults with cardiovascular risk factors in Windham County. But they’re designed to be adapted for use anywhere in the state.

Who should read it?

Everyone! That said, we asked the authors to be especially mindful of the questions that people in health care organizations might ask if they were thinking about implementing one of these programs. For each potential program, the authors included detailed budgets and projections to show the potential impact on medical costs, patients’ health, quality measures used in value-based payment arrangements, and (for three of the programs) social factors such as reduced work absences among patients who receive services from community health workers.